THE UNIVERSITY OF HULL

Transcription

1 THE UNIVERSITY OF HULL Psychological Profiles of Clerical and Non-clerical Men Who have Sexually Abused Children. being a Thesis submitted for the Degree of Psy.D. in the University of Hull by Patrick Randall, B.A., M.A.(Clin.Psych.) March, 2008 Head of Department: Professor Dominic Lam Supervisor: Professor Alan Carr

2 Acknowledgements I would like to thank the clients at the Granada Institute for participating in this study, and demonstrating how changes can be made. My thanks to Professor Alan Carr for believing I could do it, and providing encouragement and guidance. I am grateful for the support I received from Zita Radmall-Quirke and the director and staff of St. John of God s Hospital for allowing me the time to complete this study. I would also like to thank Emma-Jane Fox and Brendan Rooney for their expert assistance with the data collection and statistics respectively. My thanks also go to Dr. Barbara Dooley for making statistics understandable to me. I also owe a debt of gratitude to Dr. Jonathan Egan for his encouragement, guidance, and support. To my mother Una for her support and encouragement. To my partner, Davina, and my son Finn, thank you for the sacrifices you have made for me to complete this. Finally, to the memory of my father, Bill, who did not see this completed. i

3 Abstract This thesis examined the psychological characteristics of clerical and laymen who had sexually abused children. A three group design was used which permitted comparisons to be made between a group of 30 clerical men who had sexually abused children, a group of 73 laymen who had sexually abused children, and a group of 30 laymen who had not sexually abused children. The following instruments (all but two of which are from the Sex Offender Assessment Pack) were included in the assessment protocol: the Personal Reactivity Index, the Interpersonal Reaction Inventory, the Assertiveness Inventory, the Locus of Control Inventory, the UCLA Emotional Loneliness Scale, the Self-Esteem Inventory, the Victim Empathy Scale, the Children and Sex Scale, the SHAPS Lie Scale, the Multiphasic Sex Inventory, and the NEO Personality Inventory-Revised. Groups were compared on dependent variables using analysis of variance with post hoc comparisons for interval scale variables and found to differ significantly on 11 of 18 variables. Clerical offenders were more conscientious than lay offenders, and were more agreeable, more empathically concerned, and reported greater social sexual desirability than normal controls. But they also had lower self-esteem than the normal control group. The lay offenders had greater neuroticism, less extraversion, less openness, more agreeableness, greater emotional loneliness, more empathic concern, more personal distress, lower selfesteem, less assertiveness, and social sexual desirability than normal controls. In addition to the ANOVAs a multivariate discriminant analysis ii

4 (MDA) was completed to identify which set of dependent variables best predicted group membership. The MDA identified 2 discriminant functions that predicted group membership of 72% of participants. Function 1 which accounted for 76% of the variance, distinguished clerical and lay offenders from normal controls and included these variables: agreeableness, selfesteem, openness, social sexual desirability, extraversion, personal distress and neuroticism. Function 2, which accounted for 23% of the variance, distinguished clerical offenders from the other two groups and included these variables: under assertiveness, conscientiousness, empathic concern and emotional loneliness. iii

5 Table of Contents Acknowledgements Abstract Table of Contents List of Tables List of Figures List of Appendices Page Numbers i ii iv vi vi vii Chapter 1 Overview of the Study 1 Introduction 1 Chapter 2 Child Sexual Abuse in Ireland 2 Introduction 2 Child Sexual Abuse in Ireland 2 Chapter 3 Theories of Child Sexual Abuse 4 Introduction 4 Theories of Sexual Offending 4 Finkelhor s Model 5 Four Factor Model 6 Finkelhor s Four Preconditions 9 Critique 11 Marshall and Barbaree s Theory 13 Development of Vulnerability 14 Challenge of Adolescence 15 Situational Factors 16 Critique 17 Hall and Hirschman s Quadripartite Theory 19 Sexual Arousal 19 Cognitive Distortions 20 Affective Dyscontrol 20 Enduring Personality Traits 21 Critique 23 Ward and Siegert s Pathways Model 24 Clinical Phenomena 24 Aetiological Pathways 29 Critique 33 The Integrated Theory of Sexual Offending 34 Biological Factors 34 Ecological Niche 37 Neuropsychological Functioning 38 Clinical Symptomatology 40 Critique 44 Conclusions 45 iv

6 Chapter 4 Psychological Characteristics of Men who have Sexually Abused Children 47 Introduction 47 Search Strategy 47 Psychological Distress 49 Emotional Isolation 50 Empathy Deficits 52 Cognitive Distortions 59 Personality Variables 60 Self-Esteem 62 Sexuality 63 Locus of Control 65 Assertiveness 66 Clerical Abusers 68 Strengths and Limitations of the 27 Empirical Studies 69 Conclusions 84 Chapter 5 Methodology 86 Introduction 86 Research Questions and Hypotheses 86 Participants 87 Instruments Used 89 Life History Inventory 89 Sex Offender Assessment Pack 90 NEO PI-R 96 Multiphasic Sex Inventory 97 Procedure 99 Chapter 6 Results 100 Introduction 100 Reliability of Measures Used 100 Statistical Power 102 Differences Between Groups 102 Multivariate Discriminant Function analysis 108 Conclusion 115 Chapter 7 Discussion 116 Introduction 116 Summary of the Findings in the Light of Hypotheses 116 Predicted Group Membership 122 Limitations of the Study 123 Implications for Clinical Practice and Future Research 124 References 126 v

7 List of Tables Page Number Table 1: Psychological characteristics of child sex offenders 54 Table 2: Demographic characteristics 89 Table 3: Reliability of self report measures 101 Table 4: Results of one-way ANOVAs across groups 104 Table 5: Results of ANCOVAs 106 Table 6: Group centroid values for the 3 groups 109 Table 7: Structure Matrix: Pooled within-groups correlations between discriminating variables and standardized canonical discriminant functions 110 Table 8: Accuracy of functions in predicting group membership 110 List of Figures Figure 1: Plot of group centroids and stretched vectors for the MDA 114 vi

8 List of Appendices Page Number Appendix A Letter of information for participants 136 Appendix B Letter of consent for participants 138 Appendix C Letter of ethical approval for the study 140 Appendix D Personal Reactivity Index 142 Appendix E UCLA Emotional Loneliness Scale 144 Appendix F Locus of Control Scale 146 Appendix G Social Response Inventory 149 Appendix H Thornton Self-Esteem Scale 155 Appendix I Interpersonal Reactivity Index 157 Appendix J Children and Sex Questionnaire 159 Appendix K Victim Empathy Scale 169 Appendix L MSI: SKB, SO & SSD Scales 176 Appendix M NEO Personality Inventory Revised 179 Appendix N Biographical questionnaire 187 vii

9 Chapter 1 Overview of the Study Introduction This study aimed to identify the psychological profile of clerical sex offenders compared with lay sex offenders and a normal control group on a selected battery of psychometric tests. In Chapter 2 the problem of child sexual abuse in Ireland will be described with reference to recent empirical studies of the problem. Following this, in Chapter 3 a number of the theories that account for child sexual abuse will be examined. In Chapter 4 empirical studies of characteristics of men who have sexually abused children will be reviewed. This Chapter will conclude with a consideration of the scant research on characteristics of clerical sexual abusers, and the rationale for the present study. In Chapter 5 the methodology of the present study will be described. The results will be presented in Chapter 6. The thesis will conclude with a discussion of the results, their implications in Chapter 7. 1

10 Chapter 2 Child Sexual Abuse in Ireland Introduction This Chapter provides an empirical backdrop to the present study by presenting information on the prevalence of child sexual abuse in Ireland. Such information is contextually relevant to the study reported in Chapters 5 and 6. A number of studies have been conducted that examine the prevalence and nature of sexual abuse in Ireland (Lalor, 1999; O Reilly & Carr, 1999 in Waldron, 2003). However the Sexual Abuse and Violence in Ireland (SAVI) report (McGee, Garavan, de Barra & Byrne, 2001) provided the first authoritative national estimates of child sexual abuse figures in Ireland. Child Sexual Abuse in Ireland The SAVI team conducted a telephone survey of 3118 adults in Ireland. The telephone numbers were generated at random and the participants were interviewed using a sensitively designed structured interview to minimise the psychological distress caused to them. The interviewers used clearly defined well specified behavioural definitions of abuse experienced. The participants ranged in age from 20 to 80 years old with a gender ratio of 48.6% males and 51.4% females. The sampling methods used in this study insured that the sample was broadly representative of the general population of Ireland. 2

11 The research team found that 23.5% of men and 30.4% of women reported experiencing child sexual abuse. They reported that most of those who were victimised as children were under 12 years of age at the time of abuse, with children between the ages of 9 and 12 being most vulnerable. Those victimised reported that the strategy most frequently used by perpetrators to ensure compliance with the abuse was bribery. With regard to the perpetrators of abuse, 89% were males, 7% were females, with 4% involving more than one perpetrator. While family members were held to be responsible for 13.8% of the men victimised as children and 23.5% of the women victimised as children, the majority (65.7% of men & 50.6% of women) were victimised by non-family members known to them. According to the SAVI report, 7.2% of those perpetrating child sexual abuse were religious ministers or religious teachers. Of those who reported being sexually abused as children, a little over half noted that the abuse occurred in a single episode. However 36% of those victimised believed that their perpetrator had abused other children during the time period when they were being abused. The SAVI research team found that child sexual abuse was a significant problem for Irish society, with prevalence rates of almost a quarter of the population having experienced child sexual abuse. Also a significant minority of perpetrators were clerical offenders. These prevalence figures provide a context for the study reported in Chapters 5 and 6, which concerns the psychological profiles of clerical offenders. 3

12 Chapter 3 Theories of Child Sexual Abuse Introduction This Chapter will review the literature on a number of the predominant theories of child sexual abuse. While some of these theories might offer explanations for the sexual assault of adult victims, it is there application to child sexual abuse that will be examined. Theories of Sexual Offending Theories about sexually abusive behaviour serve to explain the causal factors of this type of behaviour and predict future sexually abusive behaviour (Ward & Beech, 2006). All such theories specify particular psychological characteristics which contribute to the aetiology of sexually abusive behaviour. The presence or absence of these theoretically derived characteristics may be assessed and the likelihood of someone committing an offence may be predicted. In addition, treatment programs may be developed that target these characteristics in order to prevent abuse from occurring in the future. In this Chapter I aim to examine the dominant theories that have informed the assessment and treatment of men who have sexually abused children. Ward and Hudson (1998) developed a meta-theoretical approach that identified three different levels of theory. Level I theories are multifactorial and represent comprehensive accounts of sexual offending. They examine the key features of sexual offenders and how these manifest through their sexually 4

13 abusive behaviour. Level II theories are single factor theories wherein a single factor and its supportive structures and processes are described and their interrelationships evaluated. Level III theories are highly specific descriptive models of the offence chain or relapse process. The major focus of this Chapter will be on the level I multifactorial theories as these provide the most thorough account of the offending process, and arguably have been more influential in their contribution to research and clinical work with those who have sexually abused children. Finkelhor s Model Finkelhor (1984) developed what became the first multifactorial account of how men sexually abuse children. The first part of his model identified four factors that provide a framework within which theoretical and empirical research data could be considered, evaluated, and integrated as appropriate. Finkelhor noted that the literature placed a significant emphasis on psychopathology and the experience of prior traumatic events, which was likely due to the fact that it was based on convicted sexual offenders who represent a small percentage of the total population of sexual offenders. In his Four Factor Model, Finkelhor set out to examine how individual psychological characteristics and broader socialisation patterns combine in order to facilitate the abuse of children. 5

14 The second part of Finkelhor s model described four preconditions that necessarily precede the perpetration of a specific sexual offence. This became known as the Precondition Model. The Four Factor Model Finkelhor identified a key question together with each of the four factors that facilitates our understanding of the individual abuser and explains the diversity present between child abusers. Factor 1: Emotional Congruence Question: Why does a person find relating sexually to a child emotionally gratifying and congruent? This factor considers how an adult might find it emotionally satisfying to relate to a child. This question emphasises the emotional rather than sexual components of the interaction. Possible answers to this question include: (1) The term congruence implies that there is a match or fit between what the adult needs and what the child can provide. The abuser and the child are thus at a similar level of emotional and psychological development. (2) The abuser is emotionally vulnerable, has a low sense of self esteem and self efficacy, and finds relationships with adults difficult and threatening. Consequently they turn to relationships with children who they find less threatening, which leaves them feeling empowered and in control. (3) The sexual abuser is attempting to gain mastery over his own experience of being sexually abused as a child by identifying with the perpetrator of his abuse by 6

15 re-enacting it with a child. (4) Sexual abusers are socialised to identify with the view that males should behave in a dominant manner in sexual relationships. Consequently, children who are smaller and physically weaker than adult males, display characteristics that adult males want in a sexual partner. The children then become inappropriate targets for this adult sexual desire and behaviour. Factor 2: Sexual Arousal to Children Question: Why is a person capable of being sexually aroused by children? Finkelhor posits that in order to understand why people are sexually aroused by children their early experiences of sexual behaviour and arousal need to be considered. He emphasises that both sexual and non-sexual factors need to be examined if we are to have an accurate understanding as to why someone might be aroused to children. Critical factors that Finkelhor identifies as contributing to sexual arousal to children are: (1) early childhood sexual experiences which due to their quality of frustration or fulfilment are particularly arousing when recalled as an adult; (2) exposure to sexual, physical or emotional abuse as a child results in the development of sexual arousal to children; (3) an early experience of sexual arousal to children becomes increasingly arousing when it is reinforced by fantasy and masturbation; (4) abusers who were raised in families where children were abused model their behaviour on the adult carers within that family, and so absorb an abusive culture; (5) abusers misattribute emotional arousal as sexual arousal, which they then reinforce through repetition and fantasy; (6) 7

16 physiological factors such as hormonal, genetic or chromosomal abnormalities predispose abusers to find children sexually arousing; (7) sexualisation of children through advertising media and child pornography facilitates an abuser s developing a pattern of arousal to children through exposure. Factor 3: Blockage Question: Why is a person blocked in efforts to obtain sexual and emotional gratification from more normatively approved sources? Finkelhor describes individual psychological factors, as well as social normative factors that prevent an abuser meeting their needs for appropriate sexual expression with adults. Repressive sexual norms may prevent people from finding an adult sexual partner outside their deteriorating marriage. These norms may also prevent people from expressing their sexual urges through appropriate fantasy and masturbation. The individual psychological factors identified by Finkelhor are developmental and situational blockage. Developmental blockages are those that refer to psychodynamic or oedipal conflicts that prevent an individual from developing appropriate sexual relationships with adult women. Situational blockage refers to a more transitory state that prevents an adult from meeting their sexual needs with adults, such as a relationship breakdown/conflict, separation from a partner or other temporary crisis. However, irrespective of the nature of the blockage, it increases the likelihood of an abuser seeking sexual gratification with children by impeding their access to appropriate sexual outlets. 8

17 Factor 4: Disinhibition Question: Why is a person not deterred by conventional social inhibitions from having sexual relationships with children? Finkelhor s final factor considers how normal inhibiting factors are circumvented in those who sexually abuse children. These disinhibiting factors are: (1) poor impulse control; (2) psychosis; (3) senility; (4) alcohol and substance abuse; (5) acute environmental stress such as unemployment, or bereavement; (6) factors that erode familial bonds such as significant periods of separation from children or father/step-daughter relationships; (7) cultural influences that promote a male dominated, patriarchal family structure where females are subservient to the needs (including sexual) of the dominant male; and (8) use of child pornography (O Reilly, 2004). Finkelhor s Four Preconditions to the Sexual Abuse of Children Finkelhor s Four Factor Model provides an explanation as to why someone might sexually abuse a child. The first three factors describe why particular people acquire a sexual interest in children, while the fourth provides some account for how these interests are acted out through the abuse of children. These factors act in interaction with each other and they may function together to cause child abuse, work antagonistically and frustrate or block each other. While any one or more of factors one to three may be present, factor four (disinhibition) is essential for child abuse to occur. 9

18 Following on from his Four Factor Model, Finkelhor (1984) identifies four preconditions that need to be fulfilled in order for abuse to occur. Essentially these preconditions describe how the aforementioned factors might be grouped in order to facilitate child sexual abuse (Ward, Polaschek, & Beech, 2006). These preconditions are: Precondition I: Motivation to Sexually Abuse This precondition refers primarily to the first three factors identified above: (1) emotional congruence with children wherein the abuser relates to a child in order to satisfy a pressing emotional need; (2) sexual arousal to children wherein the child becomes sexually arousing to the abuser; and (3) blockage wherein the sexual abuser is unable to obtain sexual satisfaction through appropriate means or relationships. As these factors are not in themselves preconditions, elements from any one of them may provide sufficient motivation to sexually abuse. However, in a significant number of cases, elements from these factors interact to provide the motivation to sexually abuse. Precondition II: Overcoming Internal Inhibitors This precondition is much the same as the fourth factor discussed previously. While an abuser might be motivated to abuse, they will not unless they are able to overcome their internal inhibitions. While this precondition is essential to the offending process, it alone is not sufficient to result in abuse, as those 10

19 who are disinhibited will not offend unless they are motivated to do so. Internal inhibitions could be overcome by substance misuse, severe stress, organic disturbances that cause poor impulse control, or distorted thinking that justifies sexually abusive behaviour. Precondition III: Overcoming External Inhibitors Once an abuser is motivated to abuse, and has overcome his internal inhibitions, he then needs to gain access to victims. The mechanisms through which abusers gain access to children are; to isolate them from their caretakers and parents via manipulation of their living conditions or environment, or by seducing them into special relationships which isolate them from their peers. The abuser seeks to maximise his time with the child away from the presence of others who might impede his abusive behaviour. Precondition IV: Overcoming the Resistance of the Child This is final precondition and it concerns how an abuser overcomes a child s resistance. Abusers might introduce victims to sexual stimuli in a graduated way, encouraging sexual curiosity and exploration by the child. They might use force or threats of dire consequences to the child or a loved one, in order to gain the victim's co-operation. Abusers might also take advantage of a victim's lack of sexual education and knowledge to "play" sexual "games". Critique Finkelhor provided a clear model that explains some of the diversity found among abusers. His recognition of the multiple aetiological factors that 11

20 contribute to child sexual abuse, gives it the status of a level I theory, while his identification of the temporal nature of preconditions III and IV, give his theory level III status. Finkelhor s theory thus accounts for the diversity of characteristics of sexual offenders and how they come to abuse at a specific moment in time. It has also provided a framework for the clinical assessment and treatment programmes for men who sexually abuse children. A major contribution of this model is that it recognises the need for a comprehensive assessment of an abuser together with an individually tailored treatment programme. However, Finkelhor s theory does not account for why, in certain circumstances, non-sexual needs are expressed in a sexual way. There is also conceptual overlap between the constructs. For example, developmental blockage where an offender is unable to meet his need for intimacy with an adult woman, and turns to a child, is very similar to emotional congruence, where an offender turns to children because they are less threatening. Another example of overlapping constructs is the similarity of disinhibition and overcoming internal inhibitions. 12

21 Marshall and Barbaree s Integrated Theory Marshall and Barbaree (1990) present a highly influential model, which concerns the development of sexually abusive behaviour. According to their model, an essential developmental task for adolescent males is to learn to discriminate between aggressive and sexual impulses. Following this they need to differentiate their responses to these impulses and control their aggressive tendencies during sexual experiences. Marshall and Barbaree contend that this is made more complicated during adolescence due to the increase in male sex hormones and steroids. This theory emphasises the developmental aspect, and examines behavioural templates that are acquired in childhood and particularly adolescence. According to Marshall and Barbaree some men have a strong predisposition to sexually abuse, while others display a high level of resilience against sexually abusive behaviour. They posit that the factors that constitute resilience to be those abilities, skills, attitudes, preferences, beliefs and values, that enable an individual to resist the urge to offend. The integrated theory identifies biological processes, developmental experiences, cultural norms and values about sex, and situational factors as important contributors that interact to result in sexual abuse. In their integrated theory, Marshall and Barbaree note that the developmental experiences of psychopaths are very similar to those who sexually abuse children. They argue that the key characteristic of psychopaths is their incapacity to respond to the emotions of others or empathise. They go on to 13

22 state that as their early family environments are similar to psychopaths, men who sexually abuse children also lack the capacity to empathise with others. The Development of Vulnerability to Sexually Abuse Marshall and Barbaree (1990) identify early childhood experiences as critical to the formation of a template for interpersonal skills, necessary to successfully negotiate the transition to adulthood through adolescence. Children who are neglected or abused will develop a view of themselves as unworthy and find it difficult to trust others. Their attachments to their caregivers and parents are insecure and they have difficulties with emotional regulation, problem solving, low self-esteem, poor judgement, impulsivity, and self-efficacy. According to Marshall and Barbaree these children are likely to experience their parents and care givers as emotionally unavailable and rejecting of them. These children would then avoid disclosing their thoughts and feeling to others and when distressed will tend to isolate themselves. This impedes their developing the capacity to elicit support and comfort from others. As a result of this their capacities to self-regulate and negotiate emotionally intimate relationships are impaired. In the case of those who have experienced child sexual abuse they are more likely to turn to masturbation, or sexually abusive behaviour for comfort, given their impaired and insecure attachments to others. Marshall and Barbaree also identify exposure to antisocial and misogynistic behaviour in the home as contributing to the development of these proclivities in the child. A child witnessing their mother being denigrated might consider women as inferior to 14

23 men, or he might learn that intimate relationships are characterised by fear, anger and violence, and are to be avoided. Children who are sexually abused could come to regard sexual contact between adults and children as mutually beneficial and normal, particularly if the abuse was pleasurable and occurred within the context of a caring relationship. The Challenge of Adolescence Marshall and Barbaree contend that the task of differentiating sexual and aggressive impulses is a particularly difficult one during puberty. They base this idea on the notion that the sexual and aggressive impulses use the same brain structures (hypothalamus, amygdala, septum, and pre-optic area), involve similar endocrine hormones and neural networks, and result in a comparable sense of arousal. Thus, given the inculcated social norms of vulnerable adolescents, they would find it difficult to know whether they were sexually aroused or angry, or both simultaneously. According to Marshall and Barbaree the templates formed in childhood set the stage for how the young person negotiates the challenging developmental tasks of adolescence. They posit that it is during this period that sexual preferences are acquired and sexual behaviour learned. Adolescents who have been subject to abusive experiences are less likely to successfully negotiate the challenge of managing their sexual urges created by the increase in male hormones at puberty. As these young people enter puberty lacking in interpersonal skills, self-confidence, and self-efficacy they find it difficult to approach and engage potential sexual partners in an appropriate 15

24 way that will facilitate relationship formation and contribute to the sustainability of these relationships. Vulnerable adolescents who have been abused as children lack a satisfactory template for sexually and emotionally intimate behaviour, they are more likely to withdraw from others, or behave inappropriately or abusively, depending on the nature of their earlier exposure. They also lack the self-confidence and social skills to cope with the inevitable rejections, and they process their resultant negative emotional states and anger towards women through aggressive, sadistic, or deviant fantasy. These may in turn be reinforced through masturbatory activities. This could result in the maintenance or escalation of this behaviour. These masturbatory experiences might reinforce their dysfunctional template for relationships, or also become rehearsals for future sexual offences. A critical aspect of Marshall and Barbaree s theory is that people meet a number of psychological and emotional needs through sexual behaviour. So, adolescents who feel emasculated by their lack of success at finding a sexual partner might achieve a sense of empowerment and self-esteem from deviant fantasies and sexually abusive behaviour. Situational Factors The integrated theory contends that the aforementioned vulnerabilities interact with transitory environmental cues or circumstances to produce sexually abusive behaviour. According to Marshall and Barbaree, these men who 16

25 sexually abuse children might purposefully create or encourage the development of these circumstances. These situational disinhibitors include substance and alcohol abuse, negative emotional states such as anger and anxiety, and the presence of stressors. Stressors include the loss of a relationship, social rejection, and loneliness. Factors that appear to condone or encourage sexually abusive behaviour might also facilitate the overcoming of normal inhibitions. These factors include pornography, alienation from potential sexual partners and anonymity. Critique Marshall and Barbaree s model offers a developmental perspective on how people come to sexually abuse children. It is a sophisticated model that integrates biological, psychological, social, cultural, and situational factors to account for child sexual abuse. As this model takes a developmental perspective it facilitates some understanding of how adolescents might sexually abuse. This model also identifies psychological vulnerabilities and resilience factors to sexual abuse. However it does not account for how those with high self-esteem might commit a sexual offence (Ward, Polaschek, & Beech, 2006). One of the deficits of the integrated theory is that it is a onesize-fits-all framework based largely upon a retrospective view of men convicted of sexual offences. In addition, the integrated theory needs empirical validation and it does not give an adequate account of how those who experience psychological distress as a result of being reared in an abusive family do not engage in sexually abusive behaviour (O Reilly, 2004). In addition, Marshall and Barbaree s fusion of sexual and aggressive motives 17

26 requires empirical support, their contention that similar brain structures are involved is not sufficient evidence of functional equivalence, as the same brain structures are involved in a number of different and sometimes competing activities. 18

27 Hall and Hirschman s Quadripartite Theory Hall and Hirschman (1991, 1992; Hall, 1996) developed their model to capture the heterogeneity of men who sexually abuse children in a cohesive, unified manner that accounted for the multiple aetiological factors that contribute to this behaviour. Hall and Hirschman identify four aetiological factors that contribute to the sexual abuse of children. These have greater or lesser importance depending upon the individual qualities of the offender and the nature of the offence. These aetiological factors are: (1) sexual arousal; (2) cognitive distortions; (3) affective dyscontrol; and (4) enduring personality traits. Sexual Arousal Hall and Hirschman posited that sexual arousal is one of the key motivating factors that facilitates the initiation of sexual behaviour. Therefore in order to perpetrate sexual offences against children, an offender should be sexually aroused by children. While the evidence for this was reportedly mixed, a number of studies found that people diagnosed with paedophilia evidenced deviant sexual urges and fantasies involving children. Hall (1996) noted that those whose abuse of children arose primarily out of their physiological sexual arousal to children were likely to have more victims, exhibit low levels of violence in their offending, and less likely to present with nonsexual aggression. 19

28 Cognitive Distortions Hall and Hirschman view cognitive distortions as a central feature in the sexual abuse of children. They argue that physiological sexual arousal is cognitively evaluated and appraised before the arousal is acted upon. Thus people who sexually offend are likely to think about their sexual behaviour or their victim in a distorted way, that facilitates their transcending their moral and societal prohibition of this behaviour, and abusing a child. Men who sexually abuse children might develop the idea that their victim wants to be abused, and think this child wants me to touch her sexually or underneath it all, children like sexual contact with adults. Offenders might also have cognitions that limit their acknowledgement of the impact of their behaviour on their victim such as there s no harm in teaching them about sex. In addition, people who sexually abuse children might consider themselves beyond detection and think no one will find out it was me. Hall and Hirschman thus argue that offenders evaluate their situation and systematically examine the costs with the benefits of committing a sexual offence, and choose the course of action that will be the most rewarding to them. Hall (1996) noted that offenders whose motivation to sexually abuse arose out of their distorted thinking, tended to exhibit a high degree of planning, little impulsivity, and higher rates of incestuous sexual abuse. Affective Dyscontrol This refers to difficulties with the accurate identification and management of emotional states. Hall and Hirschman argue that strong negative emotional states such as depression, anger, and hostility, contribute to the sexual abuse 20

29 of children. They note that these emotional states become sufficiently compelling so that they overcome the normal emotional inhibitions such as guilt, victim empathy, and moral conscience. Other researchers (Ward, Polaschek, & Beech, 2006) have noted that sexual offenders might have difficulty identifying emotional states and so they may confuse states of loneliness with those of sexual desire. Another potential difficulty identified by these researchers is that of ineffective coping with intense emotions. In these circumstances offenders might attempt to reduce the intensity of deviant sexual fantasy by masturbating, or perhaps drink excessive amounts of alcohol in order to subdue feelings of sadness. While these ineffective strategies bring temporary respite, they result in greater unhappiness in the long term. Hall (1996) noted that offenders who suffered primarily from high levels of affective dyscontrol were more likely to be opportunistic offenders, likely to exhibit high levels of violence, and predisposed to depression. Enduring Personality Traits According to Hall and Hirschman, the aforementioned factors, of sexual arousal, cognitive distortions, and affective dyscontrol are transitory states that, while they have a temporary motivating role, are not enduring dispositions or traits. Hall and Hirschman argue that these transitory states interact with more enduring traits and this interaction results in the sexual abuse of children. The enduring traits they refer to develop in response to adverse childhood experiences. Hall and Hirschman argue that these early life experiences are thus important in examining the aetiology of personality difficulties that go on to facilitate child sexual abuse. The factors they identify 21

30 as contributing to abuse facilitating personality characteristics are the experience of physical or sexual abuse, parental divorce, large family of origin, neglect, parental or sibling criminal behaviour or poor socialisation experiences. These experiences contribute to people developing enduring personality features that are selfish, remorseless, exploiting of others, hostile, aggressive, unstable, and antisocial. Hall (1996) noted that those offenders whose offending behaviour is primarily motivated by enduring personality traits are likely to have chronic personality problems/disorders, disregard for social norms and conventions, a tendency to behave aggressively, and poorer treatment outcome. While Hall and Hirschman acknowledge that environmental factors such as victim availability, sanctions, use of alcohol, peer group influences etc. play a role in the perpetration of sexual offences, the four aetiological factors are essential. The situational or cultural variables are important only in that they lower the threshold of abuse in a person who is vulnerable to abuse, and trigger a specific occurrence. Hall and Hirschman posit that sexual offenders belong to one of four categories, depending on whether their motivation is primarily: (1) sexual arousal; (2) cognitive distortions; (3) affective dyscontrol; or (4) enduring personality difficulties. They note that while offenders may be primarily influenced by one of these dimensions the others must also be present to some degree for an offence to occur. There is thus a synergy of these factors present in men who sexually abuse children, with one factor being dominant. Hall and Hirschman point out that while other subtypes of offenders could be identified, this would provide an unnecessary complication 22

31 to a model, which offers adequate explanatory depth, and consequently, would detract from the heuristic value of their theory. Critique In their quadripartite theory, Hall and Hirschman have identified distinct trajectories or pathways to sexual offending behaviour. Through their construct of a critical threshold, they also provide an explanation as to why offenders abuse at a particular moment in time, and not at others. The quadripartite theory also provides some clarification as to why some nonoffenders share some characteristics with offenders. This model recognises that sex offenders are a heterogeneous population and that there are multiple causal factors for abusive behaviour. The quadripartite theory examines the role of personality vulnerabilities and how these interact with situational variables to produce a sexual offence. However, it does not provide a detailed account of how the four factors interact to produce a sexual offence. Hall and Hirschman also do not report how the state factors (cognitive distortions, affective dyscontrol, and sexual arousal) originate. The quadripartite theory therefore appears to be a one-factor (personality) theory with three necessary states that interact in order to facilitate abuse (Ward, Polaschek, & Beech, 2006). 23

32 Ward and Siegert s Pathways Model This model was constructed as a theory knitting exercise to develop a comprehensive aetiological theory of child sexual abuse. Ward and Siegert (2002) attempted to integrate the best elements of the existing theories into an aetiological theory that provided a deep explanatory account of child sexual abuse. They thus combined what they identified as the best elements of the Finkelhor, Marshall and Barbaree, and Hall and Hirschman theories into a single theory. Ward and Siegert identified five causal pathways, each with their own distinct constellation of mechanisms arising from developmental experiences that, together with environmental factors, result in the sexual abuse of a child. These mechanisms are: (1) intimacy and social skills deficits; (2) sexual scripts; (3) emotional dysregulation; and (4) cognitive distortions. Three remaining mechanisms coagulate around a primary mechanism to form a distinct aetiological pathway to child sexual abuse. Clinical Phenomena Ward and Siegert note that all of the clinical difficulties of child sexual abusers can be categorised into four sets of clinical phenomena. The four areas of difficulty for those who sexually abuse children are: emotional regulation difficulties, deviant sexual arousal, intimacy and social skills deficits, and cognitive distortions. These clinical phenomena give rise to the mechanisms as identified by Ward and Siegert. A commonly observed difficulty for men who sexual abuse children is a lack of empathy for their victims. This might result from a failure of emotional regulation, combined with distorted thinking, 24

33 or cognitive distortions. Ward and Siegert recognise that each of these clusters could be subdivided into more specific subcategories. They also suggest that individual offenders are going to vary in the nature of the clusters of deficits they display. Thus for one offender their primary difficulty might be a lack of ability to form and sustain emotionally intimate relationships, whereas another offender might suffer from deviant sexual arousal to children. According to Ward and Siegert (2002) child sexual abusers display a diversity of deficits that make them vulnerable to sexually abuse. These deficits can be understood and conceptualised by thoroughly examining the mechanisms listed below and the pathways that develop from these mechanisms. Mechanism 1: Intimacy and Social Skills Deficits: Deficits in social skills and intimacy have been linked to early developmental experiences, and particularly to insecure attachment to the primary caregiver. Experiences of their early environment as abusive or neglectful, result in offenders feeling devalued and unlikely to receive emotional support from significant others. These men expect the world to be a hostile unwelcoming place and, consequently, tend to withdraw from interpersonal contact. Those who are insecurely attached are also more likely to have low self-esteem, poor self-efficacy, high levels of dependence, and impulsivity. Other attachment difficulties such as dismissive attachment result in fear of rejection by others. Thus offenders with this attachment style might distance themselves from others by maintaining an aloof and interpersonally cold disposition. These difficulties render them unable to function as mature, 25

34 independent adults, and compromise their ability to learn to relate appropriately with others. Mechanism 2: Sexual Scripts Ward and Siegert use the definition of sexual scripts as defined by Gagon (1990) and Money (1986). These scripts are internalised cognitive maps that provide a template for how to behave in a sexual encounter. They also offer guidance as to how to interpret other people s behaviour in a sexual encounter, and identify the internal and external prompts that signal the possibility of sexual engagement. Gagon (1990) identifies three levels at which scripts operate, these are: the internal, interpersonal, and cultural. The internal component refers to the individual s understanding of the physical, emotional and cognitive prompts associated with sex, and their interaction within particular contexts to facilitate sexual engagement. The interpersonal component refers to the assimilation and understanding of another person s behaviour that signal whether they are ready to be approached sexually, and how to best respond. The cultural component refers to the social norms and expectations that a person ought to be aware of, so that they know what is permissible within a specific context. Sexual scripts thus dictate when sex should take place, with whom, what to do, and how to interpret the internal, interpersonal, and cultural cues coupled with the various stages of a sexual encounter. Gagon contended that all sexual scripts had the same components, but the specific form and content they took varied from person to person. Thus different people might not share the same sexual preferences, and they might afford their components different levels of priority when 26

35 contemplating a sexual encounter. The differences in sexual scripts were the result of early experiences and learning. Thus a child who has been subject to sexual abuse might adopt a distorted sexual script as they do not have the cognitive or emotional maturity to place sexual behaviour within the context of specific relationships. They might therefore go on to develop dysfunctional sexual attitudes and behaviours. Other sexual script distortions that may result include: inappropriate choice of partner (animal, large age discrepancy etc.); inappropriate behaviour (sadistic behaviour, paraphilias etc.); and inappropriate contexts (sex when angry, impersonal sex, etc.). Mechanism 3: Emotional Dysregulation Emotional regulation is described as the ability of an individual to control their emotional state so that their personal goals are realised. According to Saarni (1999) there are eight key skills that facilitate emotional competence. These are: (1) awareness of one s emotional state; (2) the ability to identify other people s emotions; (3) the capability of using one s own cultural vocabulary to describe emotions; (4) the ability to respond empathically to others; (5) the capacity to alter one s own affect depending on the circumstances; (6) the ability to manage unpleasant, unwanted emotional states by using adaptive resources; (7) being able to recognise the essential role that emotions play in the initiation and maintenance of intimate relationships; (8) the capacity for emotional self-efficacy or emotional authenticity, which is the ability to experience emotions that are congruent to the specific situation. These skills are generally established in childhood through modelling the behaviour of adult caregivers. Therefore the lack of appropriate early experiences would 27

36 likely result in deficits in at least one of the eight aforementioned skills, which would adversely affect an offenders interpersonal abilities. Offenders who lack the ability to moderate their affective states might avoid emotionally arousing situations and thus avoid contact with others, or alternatively use alcohol or other substances to damp their emotional responses. Mechanism 4: Cognitive Distortions This mechanism refers to the problematic thinking styles and maladaptive beliefs that often occur in men who have sexually abused children. Ward and Siegert contend that cognitive distortions operate in two distinct ways. Firstly, they are generated by underlying schemata or implicit theories that explain other peoples behaviour, and make the world predictable. Offenders thus think in ways that make them more likely to offend. Examples of distorted beliefs or implicit theories posited by Ward and Keenan (1999) are: (a) children as sexual beings: children have the ability to enjoy sexual activity, and can make decisions about what sexual practices they wish to engage in, and with whom; (b) nature of harm: sexual activity is beneficial to people and unlikely to cause harm. In addition there are degrees of harm and some practices might be more harmful than others; (c) entitlement: some people are more important than others and their needs enjoy precedence over others; (d) dangerous world: the world is a dangerous place and people are likely to behave in an abusive or rejecting manner towards the offender; (e) uncontrollable: the world is an uncontrollable place where people exert little influence. They have emotions and sexual feelings that cannot be managed to any significant degree and things just happen. Another way in which 28

37 cognitive distortions could function would be to provide rationalisations and justifications for morally repugnant acts or behaviours. These serve to provide excuses for an offender s behaviour and maintain their self-esteem. Aetiological Pathways While each pathway towards sexually abusive behaviour has it s own distinctive profile and primary causal mechanism, all the mechanisms are interrelated. Ward and Siegert argue that all of the mechanisms are activated in service of sexually abusive behaviour, but it is the primary mechanism that recruits assistance from the other mechanisms in order to facilitate the sexually abusive behaviour. Thus one mechanism alone cannot result in a sexual offence. Pathway 1 Multiple Dysfunctional Mechanisms: These offenders have substantial flaws in all their psychological mechanisms. Ward and Siegert contend that at the core of these mechanisms is a distortion of sexual scripts that resulted from a history of sexual abuse or premature sexualisation. They hold that these deviant sexual scripts then have a cascading effect on other areas of the offender s life and result in their becoming pure paedophiles. They thus prefer sexual activity with children who are viewed as their ideal sex partners. These offenders will also have significant deficits in all the other mechanisms listed above. They will thus present with the clinical phenomena described previously, which are: emotional regulation difficulties; deviant sexual arousal; intimacy and social skills deficits; and cognitive distortions. In addition these offenders would 29